Sikorski M, Zrubek H
Genix Medical Centre, Lublin, Poland.
Eur J Gynaecol Oncol. 2003;24(2):147-50.
Human papillomavirus (HPV) proteins E6 & E7 are considered to be the constitutively expressed neoantigens in a vast majority of cervical squamous intraepithelial lesions and cancers. Data available from in-vitro, animal, and small clinical trials suggest that the immunological properties of interferon gamma might enhance early viral protein presentation, thus stimulating a cytotoxic response. In order to study this effect in vivo we undertook a trial in which 20 women with a definite diagnosis of cervical intraepithelial neoplasia (CIN) grade I or II with coexistent high-risk HPV infection (detected by the Hybrid Capture System) underwent four months observation followed by intracervical administration of INFgamma in cases without spontaneous regression (17 cases). Human recombinant interferon gamma 1-b (Imukin) was administered intracervically four times in equal doses in two-day intervals to a total dose of 6,000,000 IU. The results of therapy were verified by punch biopsy evaluation and HPV-DNA testing two months after completion, and revealed a complete response in nine women (complete regression of CIN and remission of HPV infection in 53% of treated cases) and partial response in four cases (lower grade of CIN or/and remission of HPV infection--23.5%). The differences between spontaneous (before treatment) and treatment-related regressions were significant at p < 0.05. We conclude that in selected cases (mainly young women who have not completed their procreation and are compliant with the therapy) a conservative approach to CIN management with intracervical IFNgamma injections seems to be a valuable method.
人乳头瘤病毒（HPV）的E6和E7蛋白被认为是绝大多数宫颈鳞状上皮内病变和癌症中持续表达的新抗原。来自体外、动物和小型临床试验的数据表明，γ干扰素的免疫特性可能会增强早期病毒蛋白的呈递，从而刺激细胞毒性反应。为了在体内研究这种效应，我们进行了一项试验，20名确诊为I级或II级宫颈上皮内瘤变（CIN）且合并高危HPV感染（通过杂交捕获系统检测）的女性先接受了四个月的观察，然后对未自发消退的病例（17例）进行宫颈内注射γ干扰素。将人重组γ干扰素1-b（英路因）以相等剂量分四次宫颈内给药，间隔两天，总剂量为600万国际单位。在治疗完成两个月后，通过穿刺活检评估和HPV-DNA检测对治疗结果进行验证，结果显示9名女性完全缓解（CIN完全消退且HPV感染缓解，占治疗病例的53%），4例部分缓解（CIN等级降低或/和HPV感染缓解——23.5%）。自发（治疗前）消退与治疗相关消退之间的差异在p<0.05时具有显著性。我们得出结论，在某些特定病例（主要是未完成生育且依从治疗的年轻女性）中，采用宫颈内注射γ干扰素对CIN进行保守治疗似乎是一种有价值的方法。
